First Online: 12 April 2010Received: 03 February 2010Accepted: 12 April 2010

Abstract

AimsBiventricular pacing BiP is an effective treatment in systolic heart failure HF patients with prolonged QRS. However, approximately 35% of the patients receiving BiP are classified as non-responders. The aim of this study is to evaluate the acute effects of VV-optimization on systolic heart function.

MethodsTwenty-one HF patients aged 72 46-88 years, QRS 154 120-190 ms, were studied with echocardiography, Tissue Doppler Imaging TDI and 3D-echo the first day after receiving a BiP device. TDI was performed; during simultaneous pacing LV-lead pacing 4 ms before the RV-lead and during sequential pacing LV 20 and 40 ms before RV and RV 20 and 40 ms before LV-lead pacing. Systolic heart function was studied by tissue tracking TT for longitudinal function and systolic maximal velocity SMV for regional contractility and signs of dyssynchrony assessed by time-delays standard deviation of aortic valve opening to SMV, AVO-SMV-SD and tissue synchronization imaging TSI.